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Friday, June 14, 2013

It Takes a Village

It Takes a Village

By Beth Marie Mole | June 1, 2013

Peter Piot got his first dose of global public-health work in Zaire more than 35 years ago, at the bedside of the world’s earliest Ebola patients. The scene was gruesome: patients oozed thick, dark blood from every opening and died atop the rusty springs of mattressless beds. The victims of the new, lethal virus had begun trickling into the country’s dilapidated rural clinics in September 1976. By October, Piot, a Belgian clinician who had co-identified the virus just weeks earlier, was bushwhacking through Zaire’s lush jungle and sordid politics to help stymie the outbreak. He had no experience in epidemiology and it was his first trip to the country—his first time seeing the poorly equipped clinics, with untrained staff, empty medicine cabinets, and filthy conditions.

In the months and years that followed, Piot forged lasting collaborations with local researchers and doctors in Zaire, now the Democratic Republic of the Congo, as well as with international health experts. Together, when the HIV/AIDS epidemic hit the continent a few years later, they trained clinic staff, ensured that dirty needles weren’t reused—an issue that caused the first Ebola outbreak, Piot and his colleagues discovered—and helped bring new blood tests and equipment to hospitals. By 1990, the public-health laboratory they partnered with in the city of Lubumbashi had proper blood screenings and a fully functional clinical lab.Piot’s determination to equip and train African health workers was a pioneering effort in what has come to be known as “capacity building,” defined by the United Nations as work to increase the ability of individuals, institutions, and societies to perform functions, solve problems, and set and achieve objectives sustainably. Though slow to catch on, capacity building has grown dramatically over the past several decades, with $70 million in US federal funds now dedicated annually to projects coordinated by the National Institutes of Health’s John E. Fogarty International Center.